PIONEERING HEROIN TREATMENT DOCTOR MAY BE STRUCK OFF

A world expert on the treatment of heroin addiction may be struck off
the medical register after the General Medical Council decided
yesterday that he had been irresponsible in the way he prescribed
opiates and other drugs to some of his patients.

The GMC's findings will dismay those who think Colin Brewer, founder
of the private Stapleford Centre, and his colleagues were saving
heroin addicts from crime and destitution by maintaining them on
opiates over long periods. Some of their patients say they have been
able to lead normal lives for years as a result of the treatment. But
the GMC's fitness to practise panel yesterday found that Dr Brewer
had acted irresponsibly and inappropriately towards 13 of his
patients. It will meet again to decide whether to strike him off the
medical register.

One of the Stapleford Centre patients died during a "home detox"
undertaken at Dr Brewer's suggestion. The patient, referred to as Mr
GS, 29, and his mother were given an instruction sheet and 10
prescription drugs to sedate him and ease withdrawal. The mother
failed to realise from the instructions that the patient had to be
watched 24 hours. The man vomited in his sleep and choked to death.

The GMC was highly critical of the programme, which put the patient
in charge of the drug dose and offered medical support only at the
end of a telephone. The panel "did not consider this was a safe or
suitable method of managing a patient who was being treated with
large doses of potentially dangerous drugs and supervised by
untrained carers. The instruction sheet was complex, unclear,
confusing and inadequate."

Many of the findings relate to the practice of giving patients
long-term prescriptions with the result that they had large
quantities of drugs which they may have been tempted to sell. One
patient, referred to as Mr RB, was given a five-week supply of the
opiate Phenazocine, which amounted to 1,050 tablets. Later he was
given 28 days' supply of Palfium, which came to 1,120 tablets. The
panel ruled that Dr Brewer should have told the Driver and Vehicle
Licensing Agency that another patient, Ms ST, was driving while under
the influence of drugs. She had four car accidents. Another addict
had anorexia nervosa and at one point her weight dropped to six and a
half stone, yet Dr Brewer failed to treat her for it.

Six other doctors from the centre were also before the GMC. One of
the doctors, Ronald Tovey, prescribed heroin for two patients at the
centre. The GMC panel accepted that Dr Tovey gave them heroin for
pain relief but the panel found he failed to act when tests suggested
the patient was not using the drug. The panel will meet again to
decide whether to discipline Dr Tovey and another doctor, Hugh
Kindness. It dismissed the cases against Nicolette Mervitz, Anthony
Haines, Timothy Willocks and Martin O'Rawe.